MOUNT VERNON — Social work is all about helping those who need help the most, but the stress and emotional exhaustion that comes with it often lead to a quick exit from the profession.
Up to 50% of child welfare workers are at risk for developing secondary traumatic stress (STS) related to working with traumatized children. Studies show that STS is a reliable predictor of the worker leaving the profession.
Research shows that the average state has a turnover rate of 14%-22% for child welfare caseworkers and 20% for supervisors. High turnover rates adversely affect the children and families they're trying to help because it impedes developing the stable relationship that vulnerable youth need.
Knox County is not immune to the high turnover rates and burnout associated with working with children and families. That's why Knox County Department of Job & Family Services has implemented a two-pronged approach — one immediate, the other more in-depth — to combat these issues and keep their employees whole.
Employee Assistance Program
An Employee Assistance Program through LifeWorks offers KCJFS employees immediate help when they're facing a mental health or some other challenge. It's offered at no cost to the staff and their families.
Individuals can call or video chat up to five times a year with a network of experts — many of whom hold a master's degree — on a variety of topics. Sessions are confidential; KCJFS does not know who uses the service or what the discussion involves.
If someone needs services beyond the five sessions, LifeWorks will connect them with someone locally. Local services are paid for through insurance or self-pay.
“It's something we offer to staff to try and keep them whole,” explained Courtney Lower, human resources administrator for KCJFS. “This is a passion project of mine.
“I think that it's important due to the kind of work our staff does — specifically caseworkers — in children's homes,” she continued. “They see a lot of difficult things. They have to manage their emotions and deal with children services, child support, people calling on public assistance, all times when people are not having their best days. They are taking on the emotion the client is presenting. The ability to deal with that kind of stress and trauma coming into our lives, I thought it was very important to be able to manage that.”
When you add in the potential need for crisis intervention and trauma response, Lower said it's even more important for employees to have a professional standing by.
“We hope that never happens, but the fact that we have a trained staff to turn to if we have a particularly difficult child abuse case or a child fatality is important,” she said. “Without an EAP, we are left scrambling to get those services in place.
“It's an insurance policy perhaps. We have a tool in our toolbox if needed,” she added.
Professional help is not limited to mental health and coping with secondary trauma. LifeWorks offers financial, legal, fitness, relationships, elder care, and nutritional support as well.
“Staff members don't drop their personal life when they come to work,” Lower said. “They're dealing with financial issues, legal issues, dependent care for their parents. The EAP can help with those, too. It takes a little of the burden off so that they don't feel so overwhelmed.”
Spouses and dependents can also access the network. Lower said that's important because family issues can divert employees' attention and energy.
“As a member of that household, you're also worried about things the employee is,” Lower said. “If I'm able to have this tool that the spouse can use, it can relieve the burden on the employee.”
Lower implemented the program March 1, 2020. Two weeks later, COVID-19 hit. Staff began working from home, so program information was spread virtually and via email.
“I think that perhaps the launch of the program didn't take hold as we would have liked it to because of those factors,” Lower said. “It's different seeing a PowerPoint presentation or having a person talk about it vs. reading about it.
“We are going to be more intentional this year,” she added. “The timing last year really hamstrung us.”
Knox County JFS' longer-term approach to reducing turnover and stress involves a pilot program that seeks to teach employees self-care and supervisors how to support through coaching.
A survey of 588 Ohio child welfare workers conducted by the national Quality Improvement Center for Workforce Development (QIC-WD) found that JFS' organizational culture and climate was above average in rigidity and resistance and below average in engagement. Additionally, 53% of respondents had experienced elevated STS symptoms.
Further analysis showed the root cause was related to supervision. Responding to focus groups conducted by QIC-WED, supervisors said they wanted more skills in how to coach, give feedback, and support; more time to engage in supportive supervision, not just casework; and more support from management to support caseworkers.
The focus groups also showed that front-line workers needed to develop stronger coping skills, take emotions out of their work, and learn how to self-regulate emotions and maintain healthy boundaries for self-care.
The Ohio Department of Job & Family Services partnered with the QIC-WD as one of eight national project sites testing child welfare workforce interventions. In the fall of 2018, ODJFS selected Knox and eight other counties to help create and pilot Coach Ohio, a supportive supervision intervention program.
“Turnover at children services agencies is typically up to six times the national average for all industries,” said Bret Crow, director of communications for ODJFS, via email. “At the time we applied to participate in the four-year research study by the Quality Improvement Center for Workforce Development, the opioid epidemic had further compounded turnover. And no one had even contemplated the impact of a pandemic.”
Coach Ohio combines two intervention methods:
--Resiliance Alliance (RA), which helps staff develop skills and behaviors that reduce turnover, minimize the effects of STS, and improve their well-being
--Coaching, which teaches supervisors skills in listening, questioning, giving feedback, and holding staff accountable
Lower said training includes 24 weeks of RA groups for children services administrators, middle managers, and caseworkers. Between RA sessions, supervisors use coaching to encourage staff members to practice their RA skills.
“The RA groups are centered around self-care, such as problem solving and strategies to deal with secondary trauma,” she said. “When supervisors have their weekly [staff] meetings, they'll talk about RA ideas and implementation strategies, what they learned about how to deal with things without being overwhelmed.”
Regarding the supervisors' training, Lower said, “It's a coaching mindset instead of just giving directions.”
As it did with virtually everything, Lower said COVID-19 really threw a wrench into the program.
“Having to do supervision remotely … it's different than sitting in a room and talking with a person,” she said. “We had to make adjustments on the fly.”
“Coach Ohio recognizes that supervisors can play a key role in helping staff cope with secondary trauma and manage stress,” said ODJFS' Crow. “The Knox County JFS team members have been diligent and invested partners in this work. They are committed to finding cost-efficient ways to support staff well-being in order to achieve the best possible outcomes for the most vulnerable families and children in Knox County. We have been fortunate to have them as partners on this project.”
Are the strategies working?
Thus far, 2.4% of JFS staff have accessed EAP support. While that doesn't represent a large number, Lower said voluntary feedback has been positive.
“You are not going to see a return on investment like you would in another money-making endeavor,” she said. “The return on investment is going to be tied to job satisfaction, retention, and employee engagement.
“We hope that over time, that is where we're going to see that return.”
More than one year into the Coach Ohio program, Knox and the other eight counties are now in the evaluation process.
“We do not have statistics yet because the evaluation is ongoing,” Crow said. “Over the next year, the evaluation team will continue to collect and analyze data, including examining the impact of COVID-19 on staff perceptions and behavior in addition to their focus on retention and resilience.”
Early reports from participants, however, indicate that those who participated in RA have learned how to better cope with the stress of the job, be more optimistic, and regulate the trauma they're exposed to.
“While we expect the formal evaluation to be insightful, the intervention counties have reported that the programs have been helpful and beneficial to the workforce, and feedback from participating caseworkers has been positive,” Crow said.
“We are excited to see the data and what comes out of this,” Lower said, adding that the program is not limited to children services. “There's no reason why we can't incorporate this into all of our units, because there's stress in each aspect of what they do. To have another tool in our toolbox to relieve stress, that's a great thing.”
Crow said that after the Coach Ohio study is completed, the national team will assess its impact on caseworkers' coping skills, feelings of social support among staff, job satisfaction, turnover, engagement and outcomes for children.
“The results could have implications for all 88 Ohio counties, as well as for the nation,” he said. “And best of all, if we can learn to better support caseworkers, we can better support children and families.”